Provider Demographics
NPI:1225029382
Name:DEAN, CHRISTOPHE BRUNDAGE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHE
Middle Name:BRUNDAGE
Last Name:DEAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2881 PALMERSTON DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-1024
Mailing Address - Country:US
Mailing Address - Phone:248-540-2133
Mailing Address - Fax:248-543-2628
Practice Address - Street 1:36800 WOODWARD AVE STE 210
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-0917
Practice Address - Country:US
Practice Address - Phone:248-543-3566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002756111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P0920001Medicare PIN